Sporty Mary is pain-free after new knee treatment

A pioneering operation that replaces cartilage has given new life to a mother
of two.

Mary Keal: 'I don’t take any pain killers, and I can wear high heels. I’ve even booked myself on a skiing holiday'Photo: Andrew Crowley

By Matthew Barbour

7:00AM BST 21 May 2012

Mary Keal had always been fit and healthy – yet by the time she was 45, the mother-of-two had constant pain in her left knee. Keal had been a keen skier, runner and gym-goer, and as a result, her knee’s protective cartilage had worn away so much it hurt to walk, climb stairs or even cross her legs.

“The problem was caused by me being sporty and the way my knee was aligned,” she says. “I’d had several procedures to realign my kneecap and to stimulate the growth of new cartilage, but I was still in pain.”

Like many patients with early knee arthritis, Keal was considered unsuitable for a full or even partial knee replacement. “I was told that these replacements have a shelf life of 15 years, by which time I’d only be 60 and might not have enough bone left in the joint for a repeat operation. I was miserable.”

Earlier this year, Keal, an assistant head teacher from Chalfont St Peter in Buckinghamshire, became the first person in the world to have a new type of knee resurfacing to replace missing cartilage. Instead of a knee replacement, this procedure – which is currently undergoing trials in the UK – leaves the bone structure virtually untouched, making it suitable for younger patients who may require further surgery for arthritis in the future.

Wear and tear to the articular cartilage – the tough, flexible tissue covering the surface of the knee joints – is common, with about 10,000 people a year seeking treatment. As cartilage cannot repair itself, the damage – often affecting sporty types – is permanent.

Surgeons have had limited success in repairing cartilage or stimulating its growth. Microfracture, for example, in which small holes are created in the bone to encourage growth, does not always have long-lasting results, while techniques to grow cartilage cells in a laboratory followed by a knee transplant are costly and expensive.

The new procedure, called BioPoly, uses an implant made from hyaluronic acid – a natural lubricant produced by joints – and a form of the plastic polyethylene. This creates a flexible yet strong material which, surgeons think, will mimic normal cartilage and protect the ends of joints.

Dinesh Nathwani, a consultant orthopaedic surgeon at the London Clinic who took part in the trial, says the new implant is not suitable for everyone and would benefit younger and middle-aged patients most.

“This implant has minimal interference with the bone structure,” he says. “Patients can weight-bear almost immediately after surgery, compared to several weeks of enforced rest for other procedures.”

Yet given recent concerns over hip and knee implants, people may have reservations about this new procedure. Mr Nathwani says that the 35 patients in the trial – approved by a UK ethics committee – will be carefully monitored for five years, so any problems should be identified early.

Marcus Green, orthopaedic consultant at the BMI Priory Hospital in Birmingham, says that though the new implant looks exciting, “it is not a miracle cure for arthritis”.

Keal, who had the implant inserted earlier this year at the London Clinic, is so far delighted with the result. “I’m back exercising in the gym again for the first time in years, I don’t take any pain killers, and I can wear high heels. I’ve even booked myself on a skiing holiday next year.”